“3＋2”助理全科医师培训中《临床综合课程》结业试卷分析评价  

The assessment and analysis of the graduation papers of ＂3＋2＂ assistant general practitioners training ＂comprehensive clinical course＂

作　　者：马秀华[1] 张东海[2] 徐德颖[4] 赵留庄[1] 黄东明[3] 刚君[3] 刘双[3] 

机构地区：[1]首都医科大学大兴医院院部,102600 [2]首都医科大学大兴医院消化内科,102600 [3]首都医科大学大兴医院科教科,102600 [4]首都医科大学全科医学与继续教育学院,100069

出　　处：《中华医学教育探索杂志》2016年第5期445-450,共6页Chinese Journal of Medical Education Research

基　　金：2016年度首都全科医学研究专项课题（面上）（16QK12）

摘　　要：目的根据“3＋2”助理全科医师培训中《临床综合课程〉〉2014级结业考试试卷的客观试题（A型题）答题结果，分析评价不同教学单位之间教学效果的差异性，为促进不同教学单位的教学水平均衡化提供客观依据。方法用Excel2000建立数据库，将各题的编号、分值和每名学生的成绩等数据录入计算机，并进行统计处理，求出试卷总体的难度系数、区分度及信度，计算出每一试题的难度系数、区分度；分析122名学员考试成绩的难度系数、区分度以及信度，比较6家教学单位学员对同一试题的答题正确率。结果本试卷客观试题（A型题）的试卷难度系数为0．77，区分度为0．19，信度为0．99。122名学员中最高分为47，最低分为28，学员平均得分（38．5±3．9）。在50道试题中，难度系数〈0．4的试题3道，难度系数在0．4～0．7之间的试题14道，难度系数〉0．7的试题33道，故试卷难度较低；在SO道试题中，区分度〈0．15的试题23道，区分度在0．15～0．30之间的试题17道，区分度≥0．30的试题10道，故试卷区分度较高。在50道客观试题中有20道试题各单位之间出现较大差异，其中9道试题有1-2家单位学员答题正确率明显降低；4道试题有3家教学单位学员答题正确率明显降低；有3道试题4家单位学员答题正确率明显降低：有2道试题仅1家教学单位正确率较高；有2道试题所有教学单位学员答题正确率均明显降低。这些问题与教师的教学能力、对课程的重点难点掌握不足、全科医学观念不足等因素相关。结论此次考试试卷设计基本符合培训课程的目标，试卷信度较高，适合于专业理论与能力的测验。不同教学单位之间存在的位点差异，可以为下一步促进不同教学单位的教学水平均衡化提供客观依据；各教学单位可通过集体备课等形式解决发现的重点问题。Objective Based on the objective test （A type） results of the 2014＂ comprehensive clinical course＂ graduation test of ＂3＋2＂ assistant general practitioners training, this article analyzed the differences between different teaching units, so as to provide objective basis for improving the teaching level of each unit. Method We established a database with EXCEL 2000, and put each question＇s ID and points, and the score of each student into the computer, so we could get the difficulty coefficient, distinction degree and reliability of the test paper, and calculate the difficulty coefficient and difference of each question. Then we analyzed the difficulty coefficient, the difference and the reliability of the 122 students＇ testing results, and compared the accuracy to the same question of the 6 teaching units. Result The objective test＇s （A type） difficulty coefficient is 0.77, distinction degree is 0.19, and reliability is 0.99. The highest score of the 122 students is 47 points, and the lowest score is 28 points, the average score is （38.5 ≥ 3.9） points. In the 50 questions, 3 questions＇ difficulty coefficient is less than 0.4, 14 questions＇ difficulty coefficient is between 0.4-0.7, 33 questions＇ difficulty coefficient is above 0.7, so the difficulty degree of the paper is relatively low. In the 50 questions, 23 questions＇ distinction degree is less than 0.15, 17 questions＇ distinction degree is between 0.15-0.30, 10 questions＇ distinction degree is above 0.30, so the distinction degree of the paper is relatively high. In the 50 questions, 20 questions＇ accuracy appears larger differences between each unit： 9 questions＇ accuracy has decreased significantly among 1-2 units, 4 questions＇ accuracy decreased signifi- cantly among 3 units, 3 questions＇ accuracy decreased significantly among 4 units, only 1 unit has high accuracy among 2 questions, and 2 questions＇ accuracy decreased significantly among all units. These prob- lems are related to the teachers＇ teach

关 键 词：助理全科医师培训 临床综合课程 试卷分析 教学效果提高 均衡化 

分 类 号：R197[医药卫生—卫生事业管理]